Canadian Urban Research Articles

Relationship Between Social Inequalities and Ambulatory Care–Sensitive Hospitalizations Persists for up to 9 Years among Children Born in a Major Canadian Urban Center

Hospitalizations for ambulatory care-sensitive (ACS) conditions have been considered a marker for access to timely and effective primary care, but there are few pediatric studies. Our purpose was to examine socioeconomic disparities in ACS and non-ACS admissions among birth cohorts in a universal health insurance setting. We examined ACS and all hospitalizations of children born from 1993 to 2000 in Toronto, Canada, by birth year, calendar year, and socioeconomic status (SES). SES was evaluated by using quintiles of mean neighborhood income from the 1996 Canadian census. Cohort, age, and temporal effects were described for all admissions, ACS admissions, and specific ACS conditions. Attributable risk by SES was calculated by using rates for the highest and lowest SES quintiles. Among 255,284 children born in Toronto during 1993-2001, ACS conditions were responsible for 28% of hospitalizations during the first 2 years of life and close to half of admissions during the third year. Low income was associated with 50% higher rates of ACS hospitalizations (relative risk [RR] = 1.50, 95% confidence interval [95% CI] 1.43-1.58), including asthma (RR = 1.69, 95% CI 1.54-1.86) and bacterial pneumonia (RR = 1.59, 95% CI 1.40-1.81), the leading causes of admission. Socioeconomic disparities in ACS and all admissions occurred in every cohort, every calendar year, and every age group. The relationship between socioeconomic disadvantage and both ACS and all-cause hospitalization in children was large, consistent across many conditions, remained stable over time, and persisted up to 9 years of age. These effects occurred in a universal health insurance setting without direct financial barriers to physician or hospital care. The effect of SES on hospitalizations in children in our setting appears to be mediated by factors other than financial access to care.

Canadian Library Human Resources Short-Term Supply and Demand Crisis Is Averted, But a Significant Long-Term Crisis Must Be Addressed

Canadian Library Human Resources Short-Term Supply and Demand Crisis Is Averted, But a Significant Long-Term Crisis Must Be Addressed

Gender, Income and Immigration Differences in Depression in Canadian Urban Centres

Immigrants tend to initially settle in urban centres. It is known that immigrants have lower rates of depression than the Canadian-born population, with the lowest rates among those who have arrived recently in Canada. It is established that women and low-income individuals are more likely to have depression. Given that recent immigration is a protective factor and female gender and low income are risk factors, the aim of this study was to explore a recent immigration-low income interaction by gender. The study used 2000-01 Canadian Community Health Survey data. The sample consisted of 41,147 adults living in census metropolitan areas. Logistic regression was used to examine the effect of the interaction on depression. The prevalence of depression in urban centres was 9.17% overall, 6.82% for men and 11.44% for women. The depression rate for recent immigrants was 5.24%, 3.87% for men and 6.64% for women. The depression rate among low-income individuals was 14.52%, 10.79% for men and 17.07% for women. The lowest-rate of depression was among low-income recent immigrant males (2.21%), whereas the highest rate was among low-income non-recent immigrant females (11.05%). This study supports previous findings about the effects of income, immigration and gender on depression. The findings are novel in that they suggest a differential income effect for male and female recent immigrants. These findings have implications for public health planning, immigration and settlement services and policy development.

Quantifying Technical Efficiency of Paratransit Systems by Data Envelopment Analysis Method

This research evaluates efficiency levels of individual paratransit systems in Canada with the specific objective of identifying the most efficient agencies and the sources of their efficiency. Through identification of the most efficient systems along with the influencing factors, new service policies and management and operational strategies might be developed for improved resource utilization and quality of services. The research applies the data envelopment analysis methodology, which is a mathematical programming technique for determining the efficiency of individual systems as compared with their peers in multiple performance measures. Annual operating data from 2001 to 2003 as reported by the Canadian Urban Transit Association are used in this analysis. A bootstrap regression analysis is performed to identify the possible relationship between the efficiency of a paratransit system and measurable operating or managerial factors that affect the performance of paratransit systems. The regression analysis allows for the calculation of confidence intervals and bias for the efficiency scores.

Health Care Costs and Mortality for Canadian Urban and Rural Patients with Diabetes: Population-Based Trends from 1993–2001

Background: Recent reports suggest that the health status of individuals residing in rural areas (as much as one third of the Canadian population) may be inferior to those who live in urban areas. Objective: This study compared trends in mortality and in provincial health care system costs for individuals with diabetes, according to urban/rural residence in Saskatchewan, Canada. Methods: The Canadian National Diabetes Surveillance System criteria were applied to the linked administrative databases of Saskatchewan Health to identify all individuals with diabetes between 1991 and 2001. Annual health care costs across 5 categories of health care services (physician visits, prescription medications, hospitalizations, day surgeries, and dialysis) were identified over a 9-year period (1993–2001). Costs (in 2001 Can $) and mortality rates were directly age adjusted, and comparisons were made across individuals residing in large urban, small urban, and rural areas. Results: A total of 57,774 individuals with diabetes were identified, approximately half (n = 26,656) of whom resided in rural areas. In 2001, total per capita costs were $3454 for large urban, $3427 for small urban, and $3289 for rural dwellers. Per capita costs of most individual categories were highest in large urban centers over the follow-up period with the exception of hospitalizations, which were highest among rural residents ($1444 vs $1283 for large urban residents). Despite differences in the individual cost categories, overall health care costs according to place of residence were similar. Overall, the age-adjusted mortality rates increased substantially from 12 (1993) to 18 (2001) deaths per 1000 population, although rates were similar across geographic locations. Conclusions: From 1993 to 2001, we observed systematic differences in costs of individual resource categories according to urban/rural residence in Saskatchewan, with urban dwellers with diabetes incurring greater costs in most categories. Age-adjusted total costs and mortality rates were similar, however, suggesting that rural populations with diabetes may not be as disadvantaged as commonly believed. Investing in better primary care access for all patients with diabetes may reduce downstream costs in Saskatchewan's provincial health care system.

Using satellite remote sensing to survey transport-related urban sustainability: Part II. Results of a Canadian urban assessment

The growing importance of urbanization in Canada highlights the need for nationally consistent information on major cities to support effective policy development. A spatially-explicit database, the Canadian Urban Land-Use Survey (CUrLUS), is described. It is a comprehensive source of integrated contemporary land-cover/land-use, demographic and socio-economic information as well as historic land use characterizations from earlier federal initiatives. Satellite remote sensing plays a key role in the form of provision of Landsat-based thematic classifications. The utilization of CUrLUS is illustrated in the quantification of transportation-related energy sustainability indicators, namely, density, urban compactness and land-use mix. The latter shows the greatest promise, being significantly correlated to both work-related median travel distance and percent private vehicle use. Urban transportation is complex and it is argued that indicators based solely on statistical and spatial analysis methodologies are limited in abilities to directly address specific components of this issue, for example, energy consumption. It is recommended that more sophisticated, model-enhanced indicators be developed. We also demonstrate that the land-use/urban-form information of CUrLUS will be a cornerstone in this endeavour.

Raising the profile of Canada's 9th forest region: Urban forests

A recent CIF Ottawa Valley section meeting in Carleton Place, Ontario was cause for reflection on the important role of urban forests. In spite of their well-known benefits, Canadian urban forests are under great pressure. However, recent developments in municipal planning and the creation of the Canadian Urban Forest Network show some progress — developments encouraged for the first time by the most recent National Forest Strategy. This contrasts to a historic denial by forestry organizations to include urban forests as part of "Canada's Forests" in spite of their economic and environmental significance. It also contrasts with urban forest programs initiated by the USDA Forest Service in the United States. For smaller communities like Carleton Place, urban forests are very important. They are being recognized by the community through its Official Plan, in operational guidelines and through an R.P.F.-led volunteer Urban Forest Advisory Committee. Key words: urban forests, strategic urban forest plans, Canadian Urban Forest Network, Urban Forest Advisory Committee

The Nature of Cities: Perspectives in Canadian Urban Environmental History

Capilano Canyon seems in a realm quite separate from Vancouver. Steep rock walls, mossy and wet; rapids and pools tracing a thin line from snowpack to ocean; ferns and Douglas firs—all remote from the suburbs that surround them. To descend into the park is to pass between two worlds; from one of humans, to another of nature. But traces within the park undermine this distinction. Cedar stumps display notches made by loggers, and in a remote corner a timber railway rots quietly away. These testify to Vancouver’s history of timber-cutting, when the "forest vanished and up went the city."1 Around a bend in the river, Cleveland Dam’s concrete bulk suddenly appears, storing and diverting the river, annexing it to Vancouver’s water system. Today, though, loggers and engineers have been displaced by strollers and tourists, catered to by gentle paths and a bus parking lot. The park testifies to the evolving place of nature within a Canadian city.

The Location of High Knowledge Content Activities in the Canadian Urban System, 1971-1991

It is widely recognized that certain activities have a higher capacity than others topromote economic growth and development. Many of these more dynamic activities areoften said to involve “high technology”. In this paper we first question the conceptualand operational utility of the notion “high technology”. We then propose a morestraightforward and more easily measured concept —high knowledge content—,demonstrating that activities of this nature may be found in “low tech” sectors. By means of an empirical analysis, we then attempt to contribute to a better understanding of the locational dynamics of high knowledge content activities within the Canadian urban system over the period 1971-1991. Specifically, we seek to determine if this class of activities is becoming spatially more concentrated or more dispersed across the urban system. The answer to this question is particularly important for smaller communities in peripheral regions whose economic bases are highly dependent upon “low tech” activities.

The Experience of Urban Aboriginals with Health Care Services in Canada

This exploratory study investigates the experience of Canadian Urban Aboriginal persons as consumers of health care services. Results highlight significant gaps in the training, skills, and knowledge of health care providers to optimally serve their Aboriginal patients. Also, several programs which are potentially most problematic for Aboriginal patients are identified. The discussion outlines important roles for hospital social workers in improving the care provided to urban Aboriginal patients.

Tracheotomy in a Canadian Urban Centre

Sixty-two patients requiring tracheotomy from 1998 to 2002 were followed for a mean length of 223.3 days. Outcomes were measured based on indications for ventilatory support, age, sex, length of intensive care unit (ICU) and hospital stay, and overall status at discharge. The overall mortality was 50%. Those who survived required a tracheotomy for an average of 41.6 days before decannulation; 41.2% of patients were discharged home. Information should assist families, intensivists, and physicians involved in the care of such critically ill patients. Ethical questions that arise in the care of these patients are addressed.

Suburbanization, the Vote, and Changes in Federal and Provincial Political Representation and Influence Between Inner Cities and Suburbs in Large Canadian Urban Regions, 1945-1999

This article examines the degree to which the relative growth of suburban electoral districts in Canada’s largest urban regions (Toronto, Montreal, and Vancouver) has lead to a loss of potential political influence within government on behalf of Canadian inner cities and/or to more support for right-wing political parties. The study finds that although inner cities and suburbs have increasingly diverged in their voting behavior in both federal and provincial elections, the growth of suburban electoral districts has not directly translated into a loss of representation and influence for inner cities. Instead, representation and influence within government are highly dependent upon the party that is in power. At the federal level, the dominance of the Liberal Party has meant that inner cities have tended to wield greater, and the suburbs less, influence, whereas at the level of Ontario provincial politics, the suburbs have indeed been overrepresented and found to wield greater influence within government to the detriment of the inner cities.

Canada-U.S. Metropolitan Density Patterns: Zonal Convergence and Divergence1

The paper compares density patterns of the three largest Canadian metropolitan regions with those of a sample of 12 U.S. urban areas with comparable populations. It verifies if such patterns support claims of Canadian urban distinctiveness prevalent within this country's research literature. Findings indicate that regional differences among U.S. cities are as important as cross-national distinctions. Measures of centrality and overall density place observed Canadian metropolitan areas within the same category as older U.S. East Coast metropolitan areas. Inter-city comparisons of historically and geographically defined zones suggest a period of cross-national convergence before World War II, when the inner city was developed, followed by a period of divergence from the 1940s to the 1970s, when the inner suburb was built. The development of the outer suburb, which began in the early 1970s, marks a return to cross-national convergence. These results question the continued relevance of the literature on the distinctiveness of Canadian urbanization.

Age Vitality: Perceptions of Young Canadian, Turkish and Georgian Urban and Rural Adults

This study extends previous research on age-group vitality around the Pacific Rim by examining the perceptions of urban and rural respondents from Turkey, Canada and the nation of Georgia towards young, middle-aged, and older adults. As in prior research, middle-aged targets were accorded the highest vitality, and a new age-vitality profile was associated with Georgian rural informants. Some urban-rural differences in vitality ratings emerged, and Canadians rated the vitality of older people highest. Across the three countries, Georgian respondents rated young vitality the highest and older adult vitality the lowest. The findings are discussed in terms of dimensions of social change.

Canadian Urbanism and Jane Jacobs

(2000). Canadian Urbanism and Jane Jacobs. Journal of Urban Affairs: Vol. 22, No. 4, pp. 459-461.

Caulfield, Jon, and Peake, Linda, eds. City Lives and City Forms: Critical Research and Canadian Urbanism

Find information about UTP Journals. University of Toronto Press is Canada’s leading academic publisher and one of the largest university presses in North America, with particular strengths in the social sciences, humanities, and business. The Book Publishing Division is widely recognized in Canada for its strength in history, political science, sociology, Indigenous studies, and cultural studies. Internationally, UTP is a leading publisher of medieval, Renaissance, Italian, Iberian, Slavic, and urban studies, as well as studies in book and print culture.

A Sense of Time and Place: Gilbert Stelter’s Contribution to Urban History

A Sense of Time and Place: Gilbert Steiter’s Contribution to Urban History John Taylor Abstract These remarks were presented at "The Urban Academic," a conference in honour of the retirement of Dr. Gil Steiter, September 26, 1998, at the University ofGuelph. The conference was presented by the History Department of the university. Gil Steiter was the first president of the Canadian Urban Group after it was founded in 1971 at the annual meeting of the Canadian Historical Association in St. John’s, Newfoundland. In retirement, Gil combines his writing on urban history with the hybridizing of day lilies. He is currently president of the U.S.-based Urban History Association.

Canadian Urban Landscape Examples

The Canadian Geographer / Le Géographe canadienVolume 44, Issue 3 p. 298-305 Canadian Urban Landscape Examples Toronto's postwar little Italy: landscape change and ethnic relations MICHAEL BUZZELLI, MICHAEL BUZZELLI School of Geography and Geology, McMaster University, Hamilton, Ontario, Canada L8S 4M1 (e-mail: [email protected])Search for more papers by this author MICHAEL BUZZELLI, MICHAEL BUZZELLI School of Geography and Geology, McMaster University, Hamilton, Ontario, Canada L8S 4M1 (e-mail: [email protected])Search for more papers by this author First published: 28 June 2008 https://doi.org/10.1111/j.1541-0064.2000.tb00711.xCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume44, Issue3September 2000Pages 298-305 RelatedInformation

Canadian Urban Landscape Examples ‐ 21 ‘Asian theme’ malls in suburban Toronto: land use conflict in Richmond Hill

Canadian Urban Landscape Examples ‐ 21 ‘Asian theme’ malls in suburban Toronto: land use conflict in Richmond Hill

Merging Traditional Aboriginal and Western Health Practices in a Canadian Urban Aboriginal Community

The health of Aboriginal peoples in Canada has been compared to that of people in third world countries. Shkagamik-Kwe Health Centre, an Aboriginal-based primary health centre, was recently established to address the unique needs of the Aboriginal population in one area of an urban community in Canada. The purpose of this paper is to describe the Shkagamik-Kwe Health Centre in terms of the history of its development within the Aboriginal Healing and Wellness Strategy and its current programs, with particular emphasis placed on how traditional Aboriginal healing and health practices are being utilised within a multi-disciplinary team approach.